| NPI | 1861718975 |
|---|---|
| Former Name | LISSETTE CARMONA CAMACHO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: FL PY11323) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: PR 3509) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2010-04-14 |
| Last Update Date | 2022-11-14 |